HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number:
BY
St. Lucie County
Building Permit Application RECEIVED
Planning and Development Services
Building and Code Regulation Division SEP 2 12017
2300 Virginia Avenue, Fort Pierce FL 34982 PERMITTIN(,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residentiah LL4-G1tM�',', FIL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
I Dr?r-1Dr)ozi:n 1hADDr)%/r:hAPK1T i r)rATTf)K1- I I
Address: Rq I South Kings Highway, Fort Pierce, FL 34945
Legal Description: First Source Commerce Park Condominium (OR 2522-1715) 1 )ai+ A-1 1-:2. ?hQqe I
(OR 55IQ —5Lo,-3)
PropertyTax]D#: aA11—Roo—onty)—cDo—i Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: _ Right Side:
DETAILED DESCRIPTION OF WORK::
Left Side:
Block No.
[)rywni� remd + rp-pictlatment, insulafion removal + repocei)wt
�am� otoof Uco( -p Y-e-placimm - (DrNmM cep[Qce ment Lip to'
131 Move Nordu(> A-6 bwctloo, kom ama�
CONSTRUCTION INFORMATION:'
Additional work to be ner rm a unaertnis permit— EnecK all apply:
11HVAC El Gas Tank E]Gas Piping Shutters Windows/Doors
11 Electric El Plumbing []Sprinklers Generator Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5�tni!DQ. 4--0
I
S Ft of First Floor:
CD
Utilities: Sewer []Septic
Building Height:
bWNER/LESSEE:
CONTRACTOR:
Name5flipimore Commercial Recilhi lavemcs I U
Name: Michael J. Waldrop
Acldress:_1121 C-1(OnCi& Po-Virpe-i
Company: Innovation Contracting, Inc.
City: FLY-t 9i(?XC_e State: EL
ZipCode: 34CIL40t Fax:
Phone No, !�z4oj— I IQ —,��34_c%)
Address: P.O. Box 12757
City: Fort Pierce State: FL,
Zip Code: 34979 Fax: N/A
Phone No. 772-519-9108
E-Mail: ril4N)VAISINAMA
Fill in fee simple Title H�Icler onjnext page I if different
from the Owner listed above)
E-Mail: mwaldrop@innovationcontracting.com
State or County License: CGC1511910
If value of construction is $2SOO or more, a RECORDED Notice of Commencement Is required.
Not App
Address: Qawlh KIA9, I 1191;*W. rekk�e, rl=0494�-
City: State:
Zip: Phone
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anscovenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNf R: Your failure to Record a Notice of Commencement maDr:sult,',n your paying twice for
improvements t9,f6ur property. A Notice of Commencement must be r __ d an posted on the jobsite
before the fir spection. If you intend to obtain financing, consu ender or n attorney before
commen( rN®rk or recording your Notice of Commencement. ��- /I
71 ature of Owne tractor as Agent for Owner
r
53'goturd:Bf-Cont,, ense Polder
a
STATE OF FLORFDAI,—�
STATE OF FLO DA
OF FLO
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this — day of 20 by
this_ day of 20 by
Name of person making statement
Name of person making statement
Personally Known _ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida
(Signature of Notary Public- State of Florida
Commission No. (Seal)
Commission No. (Sea 1)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
DESIG NER/ENGI NEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: _ Phone:
FEE SIMPLE TITLEHOLDER:
_NotApplicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement
improvemeg$to your property. A Notice of Commencement must be.;,
before theArst inspection. If you intend to obtain financing, consult,#ft
as
STATE OF Fl.
COUNTYOF
The.t( oing instrum t ac nowledgW before me
thi ayo . 20, y
V Rariiei 'of pe�rsc;n making statement
Personally Knowri . ' OR Produced Identification
Type of Identififallofi r-- /
(Signature of N oley Public- State of Florida )
ANrF1 M KUFFIOudil
Notary Public - State of Florida
commission # FF 234730
RECEIVED
Rev.
result in your paying twice for
led and posted on the jobsite
der or an attorney before
Siq&ture_61`��r License Holder
STAT :)F Fk�A
COUNTYOF
me
'Name of person making statement
Personally Knawn _ OR Produced Identification
Type of IdenD i n �;/
Produced 70 19
(Signature of Noory Public- State of Florida )
ANGELA M RUFF
Notary Public - State of Florida
MANGROVE
REVIEW